Increased Plasminogen Activator Inhibitor-1 Activity in Offspring of Type 2 Diabetic Patients

Gurlek A, Bayraktar M, Kirazli S.
Diabetes Care. 2000;23:88-92. 

To determine whether a dysregulation of the fibrinolytic system exists in normal glucose-tolerant offspring of type 2 diabetic patients. 

Research Design and Methods
In this cross-sectional study, 32 offspring of type 2 diabetic patients and 26 subjects with no family history of diabetes were studied. With respect to the metabolic parameters, plasma fasting and 2-hour postload (75 g glucose) glucose and insulin levels, total cholesterol, triglycerides, and high-density lipoprotein (HDL) cholesterol concentrations were determined. To evaluate the status of hemostatic factors, fibrinogen, tissue plasminogen activator (tPA) antigen level, plasminogen activator inhibitor-1 (PAI-1) antigen level, and PAI-1 activity were assessed. The statistical analyses included the Mann-Whitney U test to check the significance of differences between variables in the two groups and Spearman's rank correlation tests to check the interrelationships between the hemostatic and metabolic parameters in the offspring group. 

All subjects had normal glucose tolerance according to the American Diabetes Association criteria. Plasma fasting and postload insulin concentrations were significantly higher in offspring compared with control group (P<0.00001 and P<0.01, respectively). Plasma fasting and postload glucose, fibrinogen, tPA antigen, total cholesterol, and BMI were comparable between the groups. The offspring had significantly higher waist-to-hip ratio (WHR) (P=0.03), higher triglyceride levels (P=0.01), and lower HDL cholesterol levels (P<0.01) compared with the control group. PAI-1 antigen level and PAI-1 activity were higher in the offspring (P=0.05 and P=0.04, respectively). In the offspring group, PAI-1 activity was correlated with plasma PAI-1 antigen level (r=0.40, P=0.02), fibrinogen (r=0.45, P=0.01), and HDL cholesterol (r=-0.36, P=0.04). However, levels of tPA antigen, fasting and postload plasma glucose and insulin, total cholesterol, triglycerides, WHR, and BMI did not correlate with PAI-1 activity. 

These data suggest that normal glucose-tolerant offspring of type 2 diabetic subjects have elevated PAI-1 activity indicating to hypofibrinolysis in this group. The elevated PAI-1 activity has no association with plasma insulin concentration. 


Last Modified: 2/4/2013